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A Surge in Malaria Cases in the Eastern Health Region of Saudi Arabia During the COVID-19 Pandemic.
Alhaddad, Mousa J; Alsaeed, Ali; Alkhalifah, Ridha H; Alkhalaf, Makarem A; Altriki, Mohammed Y; Almousa, Arif A; Alqassim, Mohammed J; Alibrahim, Fatimah.
  • Alhaddad MJ; Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU.
  • Alsaeed A; Department of Internal Medicine, Infectious Disease Division, Dammam Medical Complex, Dammam, SAU.
  • Alkhalifah RH; Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU.
  • Alkhalaf MA; College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
  • Altriki MY; Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU.
  • Almousa AA; Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU.
  • Alqassim MJ; Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU.
  • Alibrahim F; Department of Internal Medicine, Infectious Disease Division, Dammam Medical Complex, Dammam, SAU.
Cureus ; 15(4): e37740, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2321523
ABSTRACT
Background Malaria transmission was stopped on most of the vast area of the Kingdom of Saudi Arabia. However, the pandemic of coronavirus disease (COVID-19) has negatively affected the efforts to control malaria. For instance, COVID-19 was reported to induce a relapse of malaria that is caused by Plasmodium vivax. Furthermore, physicians' attention toward COVID-19 can only result in neglect and delayed diagnosis of complicated malaria cases. These factors, among others, might have contributed to an increase of malaria cases in Dammam, Saudi Arabia. Thus, this study was conducted to examine the effects of COVID-19 on malarial cases. Methods The medical records of all patients who were treated at Dammam Medical Complex for malaria between July 1, 2018, and June 30, 2022, were reviewed. Malaria cases were compared between the pre-COVID-19 period (between July 1, 2018, and June 30, 2020) and the COVID-19 period (between July 1, 2020, and June 30, 2022). Results A total of 92 malaria cases occurred in the total study period. There were 60 cases of malaria in the COVID-19 period as opposed to only 32 cases in the pre-COVID-19 period. All the cases were imported from the endemic Saudi southern areas or from outside the country. Eighty-two patients (89.1%) were males. Most of them were Sundaneses (39 patients, 42.4%), Saudis (21 patients, 22.8%), and tribal peoples (14 patients, 15.2%). Fifty-four patients (58.7%) were infected with Plasmodium falciparum. Seventeen patients (18.5%) were infected with Plasmodium vivax. Another 17 patients (18.5%) had a mixed infection with both Plasmodium falciparum and Plasmodium vivax. A trend toward more infected stateless tribal patients was observed in the COVID-19 period compared to the pre-COVID-19 period (21.7% vs 3.1%). A similar trend was noticed for mixed malarial infections with both Plasmodium falciparum and Plasmodium vivax (29.8% vs 0%) with a P value of less than 0.01. Conclusion Malaria cases were almost doubled during the COVID-19 pandemic as compared to the pre-pandemic era signifying the negative effects of the pandemic on malaria epidemiology. The cases increased for a variety of causes that include alternation of health-seeking behaviors, changes in healthcare structures and regulations, and the interruption of malaria preventive services. Future research is needed to study the long-term effects of the changes imposed by the COVID-19 pandemic and to mitigate the effects of any future pandemic on malaria control. As two patients from our cohort were diagnosed with malaria based on blood smears, although they had negative rapid detection tests (RDTs), we recommend testing all the patients who are suspected to have malaria with both RDTs and peripheral blood smears.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Cureus Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Cureus Year: 2023 Document Type: Article